Dataset Information

Association between Rates of Visual Field Progression and Intraocular Pressure Measurements Obtained by Different Tonometers.

ABSTRACT: PURPOSE:To investigate the associations between intraocular pressure (IOP) measurements obtained by different tonometric methods and rates of visual field loss in a cohort of patients with glaucoma followed over time. DESIGN:Prospective, observational cohort study. PARTICIPANTS:This study included 213 eyes of 125 glaucomatous patients who were followed for an average of 2.4±0.6 years. METHODS:At each visit, IOP measurements were obtained using Goldmann applanation tonometry (GAT), the Ocular Response Analyzer (ORA) (Reichert, Inc., Depew, NY), corneal-compensated IOP (IOPcc), and the ICare Rebound Tonometer (RBT) (Tiolat, Oy, Helsinki, Finland). Rates of visual field loss were assessed by standard automated perimetry (SAP) mean deviation (MD). Linear mixed models were used to investigate the relationship between mean IOP by each tonometer and rates of visual field loss over time, while adjusting for age, race, central corneal thickness, and corneal hysteresis. MAIN OUTCOME MEASURES:Strength of associations (R2) between IOP measurements from each tonometer and rates of SAP MD change over time. RESULTS:Average values for mean IOP over time measured by GAT, ORA, and RBT were 14.4±3.3, 15.2±4.2, and 13.4±4.2 mmHg, respectively. Mean IOPcc had the strongest relationship with SAP MD loss over time (R2 = 24.5%) and was significantly different from the models using mean GAT IOP (R2 = 11.1%; 95% confidence interval [CI] of the difference, 6.6-19.6) and mean RBT IOP (R2= 5.8%; 95% CI of the difference, 11.1-25.0). CONCLUSIONS:Mean ORA IOPcc was more predictive of rates of visual field loss than mean IOP obtained by GAT or RBT. By correcting for corneal-induced artifacts, IOPcc measurements may present significant advantages for predicting clinically relevant outcomes in patients with glaucoma.

SUBMITTER: Susanna BN

PROVIDER: S-EPMC6882426 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Association between Rates of Visual Field Progression and Intraocular Pressure Measurements Obtained by Different Tonometers.

Susanna Bianca N BN Ogata Nara G NG Daga Fábio B FB Susanna Carolina N CN Diniz-Filho Alberto A Medeiros Felipe A FA

Ophthalmology 20180813 1

<h4>Purpose</h4>To investigate the associations between intraocular pressure (IOP) measurements obtained by different tonometric methods and rates of visual field loss in a cohort of patients with glaucoma followed over time.<h4>Design</h4>Prospective, observational cohort study.<h4>Participants</h4>This study included 213 eyes of 125 glaucomatous patients who were followed for an average of 2.4±0.6 years.<h4>Methods</h4>At each visit, IOP measurements were obtained using Goldmann applanation to ...[more]

PMID: 30114419

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Project description:Importance:Twenty-four-hour intraocular pressure (IOP) patterns may provide more information regarding rates of visual field progression than office-hour measurements. However, little is known about the added value of 24-hour monitoring when stratifying glaucoma risk based on rates of progression. Objective:To test the hypothesis that 24-hour IOP-related patterns recorded with a contact lens sensor (CLS) correlate with prior rates of visual field progression. Design, Setting, and Participants:A multicenter, retrospective cohort study was conducted at 50 ophthalmology care centers in 13 countries. Participants included 445 patients (445 eyes) with treated, manifest open-angle glaucoma. The study was conducted from November 8, 1999, to September 17, 2016. Interventions:Twenty-four-hour recordings of IOP-related patterns were prospectively collected with a CLS system. Retrospective visual field data of patients who underwent at least 3 prior reliable visual field tests were examined. Main Outcomes and Measures:Association between CLS variables and rates of visual field mean deviation (MD) change. Results:Of the 445 patients included, 238 (53.5%) were women and 394 (88.5%) were white. The mean (SD) age and MD values at the time of CLS recording were 68.9 (11.2) years and -9.0 (7.0) dB. The mean rate of MD change was -0.46 (0.5) dB/y in 5.2 (3) years of follow-up. After adjusting for baseline MD severity, age, and treatment, the following CLS variables were associated with fast visual field progression: mean peak ratio while awake (??=?-0.021; 95% CI, -0.04 to -0.003), number of long peaks during sleep (??=?0.036; 95% CI, 0.005 to 0.067), night bursts ocular pulse frequency SD (??=?0.027; 95% CI, 0.004 to 0.051), and night bursts ocular pulse amplitude SD (??=?19.739; 95% CI, 1.333 to 38.145). Regression models including CLS variables had better fit than Goldmann IOP when testing the association with rates of progression. Conclusions and Relevance:Results of this study indicate that 24-hour CLS recordings may be associated with prior rates of visual field progression of glaucoma. This association appears to be better than Goldmann mean IOP measured multiple times during office hours. Therefore, the CLS may be useful to assess the risk of future functional loss, even in situations when insufficient historical visual field information is available.

Project description:PurposeLongitudinal testing plays a key role in glaucoma management. Variability between visits hampers the ability to monitor progression. It has previously been shown that average intraocular pressure (IOP) exhibits seasonal fluctuations. This study examines whether visual field sensitivity also exhibits seasonal fluctuations and seeks to determine whether such fluctuations are correlated to seasonal IOP effects.DesignComparative case series.ParticipantsA total of 33 873 visits by 1636 participants enrolled in the Ocular Hypertension Treatment Study. Participants were split into 6 geographic zones according to the prevailing climate in their location.TestingAt each visit, standard automated perimetry was conducted on each eye, and IOP was measured.Main outcome measuresMixed effects regression models were formed to look for sinusoidal periodic effects on the change in perimetric mean deviation since the last visit (?MD) and on IOP, both overall and within each zone.ResultsWhen all the data were included, a significant seasonal effect on ?MD was found with magnitude 0.06 dB, peaking in February (P < 0.001). Five of the 6 geographic zones exhibited significant seasonal effects on ?MD, peaking between January and April, with magnitudes ranging from 0.04 dB (P = 0.049) to 0.21 dB (P < 0.001). Zones with greater climactic variation showed larger seasonal effects on ?MD. All 6 zones exhibited a seasonal effect on IOP, peaking in January or February, with magnitudes ranging from 0.14 to 0.39 mmHg (P ? 0.02 in all cases). However, there was no evidence of a significant association between the magnitudes or dates of peaks of the 2 seasonal effects.ConclusionsThe mean deviation was significantly higher in winter than in summer. There is no evidence of an association with seasonal IOP fluctuations. The cause of the seasonal effect on visual field sensitivity is unknown. These findings may help shed light on the glaucomatous disease process and aid efforts to reduce test-retest variability.

Dataset Information

Association between Rates of Visual Field Progression and Intraocular Pressure Measurements Obtained by Different Tonometers.

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Association between Rates of Visual Field Progression and Intraocular Pressure Measurements Obtained by Different Tonometers.

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